Starting Aromatize Inhibitors Years after Diagnosis

Starting Aromatize Inhibitors Years after Diagnosis

Dear OncoLink "Ask The Experts,"

I have Stage I breast cancer and was treated with lumpectomy and radiation. I tried tamoxifen for about 9 months and then stopped because I was worried about stroke and didn't like the side effects. I was diagnosed in November of 2002 and stopped taking tamoxifen by December of 2003.

All is fine, yet I went to the surgeon (he happens to be new, my original surgeon moved) and he asked why I wasn't taking Arimidex. Maybe he was just curious, but so my question is this: haven't I passed the window of opportunity? What percentage would I gain from starting it now and how long would I take it? It has been nearly 2 years [since I stopped].

Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:

The benefits would likely be minimal. I wouldn't recommend it at this point. All the benefits of Arimidex are based on clinical trials in which the drug was generally started within three months of the diagnosis.

It is possible that the surgeon was thinking you may have or should have switched from tamoxifen to Arimidex back when you discontinued the tamoxifen. Regardless, there are no clear data to support the use of Armidex at this time point in your history.